Day 2 :
- Oncology Nursing
Singapore Cancer Society, Singapore
Dr B Srilatha has a PhD in Sexual Medicine from the National University of Singapore (NUS) and a post graduate medical degree from Madras University (India). Based in Singapore, she works as Clinical Sexologist & Senior Researcher under Psychosocial Support Services, Singapore Cancer Society. She is an active member of the International Society for Sexual Medicine (ISSM) representing the Communications Committee and is in the Executive Committee of the Asia Pacific Society for Sexual Medicine (APSSM). Her seminal contributions were awarded the prestigious Emil Tanagho Prize for Best Innovative Research in Sexual Medicine at the 12th World Congress of Sexual Medicine in Cairo, Egypt (2006) and the Best of the Top 10 Basic Science Papers Prize at the Annual Fall Meeting of the Sexual Medicine Society for North America (2011). She has impactful publications in leading international referenced journals. She is a council member of Asia-Oceania Federation for Sexology (AOFS) and the Vice-President of Singapore’s Society for the Study of Andrology and Sexology (SSASS).
The diagnosis and clinical course of cancers have immediate as well as lasting impacts on the quality of relationship, intimacy, sexuality and overall life of patients and their partners. In spite of its rising awareness as an integral part of holistic health, sexual concerns in this isolated group are often neglected and underserved within the clinical care provision. Studies indicate that the sexual readjustment or rehabilitation is a major challenge for a collective prevalence of sexual disorders in about 30%–90% of this subpopulation. Clinically, a significant number of these patients may present with declines in the important domains of their sexual response cycle. In a vast majority, the issues can be further aggravated by negative psycho-emotional attitudes including stigma, low self-esteem and altered body image perceptions. Together with oncological advances in early detection and treatment, there is significant improvement in the long-term survival and post-treatment life expectancy of cancer patients. It is therefore imperative for the healthcare professionals to identify interventional measures that will succeed in recovering the sexual quality of life for their patients as well as partners. Identified modalities should incorporate a systematic assessment, intervention and follow-up for the sexual problems, psychosexual counseling and couple therapy and appropriate referral (if necessary), for a meaningful and lasting improvement on the overall symptoms and quality life care of their cancer patients and partners.
Shahid Beheshti Universit, Iran
F.Estebsari has completed his PhD in health education and health promotion to Iran University of Medical Sciences.
Now, she is faculty member of Nursing and Midwifery school in Department of Community Health Nursing of Shahid Beheshti University of Medical science. Interests research into lifestyle and cancer is. . She has published more than 29 papers in International journals .
The following are some of the newest articles are published.
Introduction & Aim: Death is a natural and frightening phenomenon which is inevitable. Previous studies on death which presented a negative and tedious image of this process are now being revised and directed towards acceptable death and good death. One of the proposed terms about death and dying is “good death” which encourages dealing with death positively and leading a lively and happy life until the last moment. Objectives: The present study aimed to explain the Iranians views about criteria of good death.
Methods: This qualitative study was performed by the thematic- framework analysis. In this study 8 patients, 3 their families, 3 physicians, 3 nurses, 3 psychologists and 3 clergymen were selected. A total of 25 people were interviewed. The sampling method was homogeneous in the process of qualitative research and the sample size was based on the data saturation. Data were collected by semi – Structured interview. All interviews were transcribed in fewer than 24 hours. The thematic framework method was used to analyze qualitative data. MAXQDA software was used for data management.
Results: 10 main themes include death at the right time, death without cost, death without bothering to others, death without dependency with control, death in peace, death without difficulty, not dying a loan dying at home and death near the family, inspired death, programmed death were recognized as participant’s views about good death criteria in this study.
Conclusion: paying attention to conditions and factors that make good death from health policy makers and provide quality service for cancer patients in the end stage of life may be helpful for patients to experience good death.
Keywords: breast cancer patients; End Stage Life; Good Death, Qualitative Study.
Imperial College London, United Kingdom
Dr. Reetoo Banarsee is a Visiting Professor at Imperial College London. He is an experienced senior management executive with a proven track record in a wide field of NHS including 20 successful years providing research, strategic and operational management within clinical services and educational establishments with a strong track record performance within primary care, research, public and mental health services. Have worked extensively with industry to deliver commercial research and develop long-term partnerships and platforms for commercial trials. He has led over 30 research projects for the NHS including a study on palliative care on End of Life. Currently he leads an International MPH programme for Africa.
Given the choice, people want to die in their own homes, supported by their family and friends, be in their own community and have access to effective services. However, it is acknowledged that a great deal more can be done. People are unable to access the care they need in the community setting of choice and family as the carers are being left with the burden of the care. Seventy percent of people express a desire to die in their own home yet less that 20% achieve this. This is a case study for a vision for a model of service for end of life care, identifies the key issues and gaps in service delivery and articulates how services will commit to achieve this vision over the next four years. The model being developed in the UK involves working with key providers to realign and better integrate services that are provided to support people towards the end of their life including terminal care. It maximises the dignity of the person at end of life as well as relieve as much as is possible the stress for them and their carer’s and/or family. It is co-produced with patients and carers
The project uses an Equality Impact Assessment tool to better understand how to carry out targeted engagement and ensure that a representative sample of patients and carers are given the opportunity to inform service design. Central to this is the ability to monitor via provider contracts patient and carers experiences of services and use data from experiences of services. Engagement and involvement is an on-going process and include, but not be limited to patient/resident groups. This strategy has been produced and refined by harnessing patient and carer views both nationally and locally.
Sevil Inal has completed his PhD at the age of 34 years from Istanbul University, Pediatric Nursing Department. She worked in pediatric oncology unit as nurse. She is the Assoc. Prof. Istanbul University, Faculty of Health Sciences, She has published more than 14 papers in sciences citation indexsed (sci-e) journals.
Aim: In this study, it was aimed to qualitatively analyze the feelings, thoughts and meanings of the nurses who had experience in child hematology in the past.
Method: In this qualitative study, in-depth interviews were conducted with 15 nurses between 29 and 53 years of age who had previously worked in child hematology-oncology unit. Interviews were conducted with a semi-structured interview form. Each interview lasted 20-30 minute. Some of the questions are: What kind of experiences do you experience when you think about the periods you are working in hematology-oncology service? Do you explain the reason for living these feelings? The data were analyzed with QSR NVivo 7 software.
Results: From the perspective of the nurses who had experience working in the pediatric hematology-oncology service in the past, five main themes and sub-themes related to emotions and thoughts towards this experiment were identified in the study. 1) Positive and negative emotions: (a) fear and anxiety, (b) desperation, pity, guilt, (c) burnout, (d) longing; 2) Being coping 3) Professional implications 4) Meaning of life 5) Unmet needs and suggestions.
Conclusions: Working in hematology should be viewed as a multidimensional situation that affects the way nurses view their profession and life, leading to a wide range of emotional lives. Data obtained from this study can be used to strengthen hematologic nurses.
Keywords— cancer, child, care, hematology, nursing
Will be updated soon
Background: The effect of second-hand smoking (SHS) on breast cancer etiology is controversial. Genetic variants of the enzyme N-Acetyl-transferase 2 (NAT2) which is involved in the metabolism of tobacco carcinogens, may modify the association between SHS and breast cancer. The aim of the current study was to evaluate the relationship between SHS and breast cancer risk by NAT2 variants in Arab women in Israel, a unique population with high exposure to SHS and low active smoking and alcohol consumption rates.
Methods – This is a population-based case-control study consisting of never-smoking Arab women aged 30-70 from Northern Israel: 137 prevalent (diagnosed in 2008-2013) breast cancer patients and 274 population- based controls. All participants were interviewed using a detailed questionnaire relating to past and current exposure to SHS and to socio-demographic, gynecological and obstetric characteristics. Each participant provided a buccal smear for NAT2 genotype analyses. Logistic regression models adjusted for potential confounders and stratified by NAT2 variants were used to assess the association between SHS and breast cancer.
Results – SHS was associated with breast cancer risk with an adjusted odds ratio (OR) of 2.14 (95% confidence interval, CI 1.21-3.78). Higher exposure to SHS was associated with higher risk of breast cancer compared to never exposed women, those exposed to SHS during childhood, adolescence and currently had an OR of 3.60 (95% CI 1.85-7.21) while those exposed during adolescence and currently but not during childhood had an OR of 1.73 (95%CI 1.05-2.86). NAT2 variants did not modify these associations.
Conclusions - SHS exposure in Arab women that never smoked is associated with increased risk for breast cancer. NAT2 genetic variation does not seem to play a role in the association. Additional studies are needed in order to support these findings.
University of State of Rio de Janeiro, Brazil
Rafael T Jomar is a Nurse, a Master in Nursing and a PhD in Epidemiology. He is currently an Assistant Professor at University of State of Rio de Janeiro (Brazil) where he teaches and researches clinical and oncological nursing in undergraduate and postgraduate courses. His most recent scientific publications have dealt with the diagnostic stage of the nursing process in different scenarios of the care of patients with cancer. More information at http://lattes.cnpq.br/1420764617102430.
Statement of the Problem: Knowing that cancer patients are frequently treated with antineoplastic outpatient chemotherapy, nurses working in oncology outpatient services should provide care with a focus on the individual’s needs, using the nursing diagnosis as a tool in the context of nursing process for selecting interventions with the goal of improving patients’ responses to the proposed antineoplastic treatment. Considering the lack of publications on nursing diagnosis in oncology and the fact that knowledge of common nursing diagnoses (NDs) in this area can strengthen the nursing process, in addition to providing oncology nurses with support for decision-making choosing the best interventions, and performing a quality clinical practice, the objective of this study was to search in the scientific literature for NDs identified in adults/seniors undergoing antineoplastic chemotherapy in an outpatient setting. Methodology & Theoretical Orientation: Review of studies published in Portuguese, English, or Spanish which were searched in five electronic databases in March 2016, using the descriptors nursing process, nursing diagnosis, neoplasms, drug therapy and hospital outpatient clinic. Findings: In the four studies selected for review, 40 NDs were identified, namely unbalanced nutrition, less than body requirements, risk for deficient fluid volume, diarrhoea, fatigue, impaired home maintenance, deficient knowledge, disturbed body image, interrupted family processes, ineffective sexuality pattern, anxiety, powerlessness, fear, readiness for enhanced religiosity, risk for infection, impaired dentition, risk for impaired skin integrity, acute pain, and nausea. Conclusion & Significance: Given the scarcity of publications on the diagnostic phase of the oncology nursing process, the 40 NDs identified by the present review point to the complexity of the care provided to patients undergoing chemotherapy in an outpatient setting. If used as a guide for the investigation of NDs among adult/elderly users of oncology outpatient services, the results of this review may contribute to the advancement and improvement of the nursing process.
Lorestan University, Iran
Heshmatolah Heydari has his expertise in community health nursing. His interest is delivery of home health care to chronic disease. Currently he is assistant professor in Lorestan University of Medical Sciences, Iran.
The increasing prevalence of chronic diseases throughout the world is an undeniable phenomenon, In fact, 13% of all deaths related to chronic diseases are caused by cancer and the majority of cancer patients expire in the intensive care units (ICU), whereas bed occupancy of ICUs is in crises. In this situation, firstly, a number of patients do not have access to the ICU beds, and secondly, because of the need to ICU beds, the admitted patients in ICU wards are discharged earlier. WHO introduced home-based palliative care to improve the quality of life, quality of care, quality of death and patient satisfaction; decrease burnout in staffing and mortality in hospitals; reduce the cost, accept end of life as live days; neither accelerate death nor prolong life; consider all dimensions of human; help the patients to be active until the time of death; help the patient’s family to cope with the disease and loss of patient; and release the beds in hospitals. Although hospital beds are considered for healing the patients not a hospice for them, the majority of cancer patients die in the hospital and on the ICU beds, and to the last moments of life, they receive specialized cure, and occupy ICU beds. Cancer patients in health system of Iran receive specific treatment and chemotherapy even to moment of death. To consider countless benefits of home care and the patients’ desire to receive services at home, if we can provide the conditions that at least 20% of end stage cancer patients in receive home based palliative care, 1000 deaths will occur at home yearly, and 1000 ICU beds will be released for use for other patients with better prognosis for survival. Therefore, health system authorities in Iran should considered home-based palliative care of cancer patients as a priority.
Manipal University, India
Fatigue is very much common among cancer patients and it has bearing on their lives during disease and treatment. Cancer-related fatigue (CRF) experience is personal (subjective) and has got different factors attributed to it.
Most of the recently diagnosed patients of breast cancer report severe fatigue. Fatigue is significantly associated with psychological symptoms like anxiety and depression.
Almost 77% of the people receiving external beam radiation therapy for breast cancer experience fatigue. For patients on external beam radiation therapy, fatigue increased gradually during the course of radiation treatment.
Many interventions are tried out for treating cancer related fatigue with varying results. Some of them are psycho-stimulants, erythropoietin, exercise, psychosocial interventions and Yoga.
Yoga is the union of the individual self (Jivatma) with the Universal self (Paramatma). The system was first collated and written down by Patanjali in his Yoga Sutras or Aphorisms. Yoga has been used as interventions for stress and coping, pain reduction, emotional well- being, anxiety and blood pressure etc.
Yoga has shown to alleviate the side effects of cancer treatment such as cancer related fatigue and to improve the quality of life. Yoga was found to be effective in reducing cancer related fatigue among patients and survivors as well.
University of Victoria, Canada.
Will be updated soon
What is a woman? This is part of the question and I suggest, motivation that currently has some women enduring lengthy reconstructive procedures post mastectomy. Nurses, play an important role in women’s health, and have an opportunity to explore, within this population of women, ideas about beauty, femininity, sexuality and being a woman, as well as the meaning they attach to their breasts and how these might be embodied post-mastectomy.
In this presentation, will provide an overview of how the female breast has been conceptualized in the West, followed by sections on how aesthetics, beauty and appearance are fundamental to reconstructive practices for women post mastectomy in contemporary society. Current reconstructive options for women post mastectomy will be discussed, emphasizing the invasiveness that women are willing to endure, in order to attain or maintain, that which is considered ‘normal’ or ‘ideal’ by society’s heteronormative standards. Lastly, the concepts of body image, femininity and sexual identity will be explored, contemplating alternative options such as choosing to adorn the mastectomy site with a tattoo. Threaded throughout, are some personal reflections and experiences I have had as a woman treated for breast cancer.